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- W2894980820 abstract "Introduction: Parenchymal-sparing management with local surgical and/or thermal ablation is the new standard treatment for CLM. However, thermal ablation is contraindicated near deep vessels due to the risk of thrombosis. We report on the safety and surgeon feasibility of CLM management with a new generation of Microwave Thermal Ablation (MTA). Methods: Patients were included prospectively in two HPB expert centers when CLM was: ≤ 3cm of diameter and located near (≤5mm) significant vessels (≥3mm). A standardized treatment (watt/duration) was applied to CLM related to their size under ultrasound monitoring. The primary endpoint was the safety by review of vessel thrombosis from abdominal computed tomography at postoperative days (POD) 7 and 30. Results: From Mars-2015 to December-2017, 34 patients/49 lesions were ablated in unique (74%;n=25) or multiple (26%;n=9) MTA procedure. CLM localization was predominantly close to hepatic veins (79%;n=27). Liver resection was associated in 62% (n=21) of the patients. At POD 30, there was no mortality or vessel thrombosis and one patient (3%) experienced severe complication due to left pleural effusion (Clavien grade IIIa). All patients had access to adjuvant chemotherapy within the recommended time. Conclusion: This study shows that CLM ≤3cm near deep vessels can be managed safely with a new generation of thermal ablation. In the era of parenchymal-sparing liver surgery, the reproducibility of MTA shows that it should be a part of the toolbox” of modern surgeons. Early postoperative recovery could lead to an oncological benefit by allowing timely access to adjuvant chemotherapy." @default.
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- W2894980820 date "2018-09-01" @default.
- W2894980820 modified "2023-10-14" @default.
- W2894980820 title "Management of colorectal liver metastasis (CLM) close to vascular axes in parenchymal-sparing era: liver-surgery 2.0 bi-centric pilot study" @default.
- W2894980820 doi "https://doi.org/10.1016/j.hpb.2018.06.2622" @default.
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